Despite expanding roles in schools, occupational therapists have been restricted from bridging to formal education leadership roles. Most State Departments of Education do not provide educational credentialing to occupational therapists, which restricts them from administrative training and positions. This qualitative research explored (a) perceived policy facilitators/barriers and (b) leadership qualities occupational therapists possess/could develop to become effective, credentialed education leaders. Historical information was gathered from occupational therapy and education archives and interviews with occupational therapists in school leadership positions. Thematic analysis revealed barriers to occupational therapists’ leadership credentialing including competition with general and special educators for state licensure, role delineation, medical reimbursement, and education legislation. Facilitators included occupational therapists’ expertise in child development, service delivery, and general leadership. This research indicates that occupational therapists are well suited for educational leadership positions, but will need to advocate through their state legislation to open opportunities for formal educational leadership training and credentialing.